Clinical significance and predictors of oncologic outcome after radical prostatectomy for invisible prostate cancer on multiparametric MRI
Abstract Background The objective of our study was to evaluate the clinical significance of invisible prostate cancer (iPCa) on multiparametric magnetic resonance imaging (mpMRI) by analyzing clinical parameters and oncologic outcomes. Methods We retrospectively reviewed the records of patients trea...
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| Format: | Article |
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BMC
2018-11-01
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| Series: | BMC Cancer |
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| Online Access: | http://link.springer.com/article/10.1186/s12885-018-4955-8 |
| _version_ | 1818995116978733056 |
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| author | Doo Yong Chung Dong Hoon Koh Hyeok Jun Goh Min Seok Kim Jong Soo Lee Won Sik Jang Young Deuk Choi |
| author_facet | Doo Yong Chung Dong Hoon Koh Hyeok Jun Goh Min Seok Kim Jong Soo Lee Won Sik Jang Young Deuk Choi |
| author_sort | Doo Yong Chung |
| collection | DOAJ |
| description | Abstract Background The objective of our study was to evaluate the clinical significance of invisible prostate cancer (iPCa) on multiparametric magnetic resonance imaging (mpMRI) by analyzing clinical parameters and oncologic outcomes. Methods We retrospectively reviewed the records of patients treated with radical prostatectomy (RP) from 2010 to 2015 at our institution. Before RP, all patients were confirmed to have prostate cancer based on prostate biopsy. We excluded patients who underwent neoadjuvant therapy. Additionally, we excluded patients who had incomplete mpMRI based on PI-RADS (Prostate Imaging Reporting and Data System). iPCa was defined as having no grade 3 or higher region of interests using a scoring system established by PI-RADS without limitations on interpretation from mpMRI by radiologists. We selected patients with iPCa using this protocol. We analyzed data using univariate and multivariate cox regression analysis, logistic analysis, Kaplan-Meier curves, and receiver operator characteristic curves to predict biochemical recurrence (BCR). Results A total of 213 patients with iPCa were selected according to the patient selection protocol. Among them, pathological findings showed that Gleason score (GS) G6, G7 and ≥ G8 were present in 115 cases (54.0%), 78 cases (36.6%), and 20 cases (9.4%), respectively. Further, extracapsular extension (ECE), positive surgical margins (PSM), and lymphovascular invasion (LVI) were present in 28 (13.1%), 18 (8.5%), and 3 cases (1.4%), respectively. Seminal vesicle invasion (SVI) was observed in one case (0.5%). During a median follow-up time of 51 months, BCR was observed 29 cases. Adverse pathology (AP) was defined as GS ≥8, ECE, SVI and LVI. AP and prostate specific antigen (PSA) were significantly associated with BCR. Moreover, PSA > 6.2 ng/ml was suggested as a cut-off value for predicting BCR. Conclusions In our results, cases of iPCa had clinically significant PCa, and AP and poor prognosis were also observed in some. Additionally, we found that PSA is the most clinically reliable predictor of oncologic outcome. We suggest that active treatment and diagnosis should be considered for patients with iPCa with PSA > 6.2 ng/ml. |
| first_indexed | 2024-12-20T21:08:44Z |
| format | Article |
| id | doaj.art-0f813f91ecd54b3494e4a93d2af7ca15 |
| institution | Directory Open Access Journal |
| issn | 1471-2407 |
| language | English |
| last_indexed | 2024-12-20T21:08:44Z |
| publishDate | 2018-11-01 |
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| series | BMC Cancer |
| spelling | doaj.art-0f813f91ecd54b3494e4a93d2af7ca152022-12-21T19:26:33ZengBMCBMC Cancer1471-24072018-11-0118111010.1186/s12885-018-4955-8Clinical significance and predictors of oncologic outcome after radical prostatectomy for invisible prostate cancer on multiparametric MRIDoo Yong Chung0Dong Hoon Koh1Hyeok Jun Goh2Min Seok Kim3Jong Soo Lee4Won Sik Jang5Young Deuk Choi6Department of Urology, Urological Science Institute, Yonsei University College of MedicineDepartment of Urology, Urological Science Institute, Yonsei University College of MedicineDepartment of Urology, Urological Science Institute, Yonsei University College of MedicineDepartment of Urology, Urological Science Institute, Yonsei University College of MedicineDepartment of Urology, Urological Science Institute, Yonsei University College of MedicineDepartment of Urology, Urological Science Institute, Yonsei University College of MedicineDepartment of Urology, Urological Science Institute, Yonsei University College of MedicineAbstract Background The objective of our study was to evaluate the clinical significance of invisible prostate cancer (iPCa) on multiparametric magnetic resonance imaging (mpMRI) by analyzing clinical parameters and oncologic outcomes. Methods We retrospectively reviewed the records of patients treated with radical prostatectomy (RP) from 2010 to 2015 at our institution. Before RP, all patients were confirmed to have prostate cancer based on prostate biopsy. We excluded patients who underwent neoadjuvant therapy. Additionally, we excluded patients who had incomplete mpMRI based on PI-RADS (Prostate Imaging Reporting and Data System). iPCa was defined as having no grade 3 or higher region of interests using a scoring system established by PI-RADS without limitations on interpretation from mpMRI by radiologists. We selected patients with iPCa using this protocol. We analyzed data using univariate and multivariate cox regression analysis, logistic analysis, Kaplan-Meier curves, and receiver operator characteristic curves to predict biochemical recurrence (BCR). Results A total of 213 patients with iPCa were selected according to the patient selection protocol. Among them, pathological findings showed that Gleason score (GS) G6, G7 and ≥ G8 were present in 115 cases (54.0%), 78 cases (36.6%), and 20 cases (9.4%), respectively. Further, extracapsular extension (ECE), positive surgical margins (PSM), and lymphovascular invasion (LVI) were present in 28 (13.1%), 18 (8.5%), and 3 cases (1.4%), respectively. Seminal vesicle invasion (SVI) was observed in one case (0.5%). During a median follow-up time of 51 months, BCR was observed 29 cases. Adverse pathology (AP) was defined as GS ≥8, ECE, SVI and LVI. AP and prostate specific antigen (PSA) were significantly associated with BCR. Moreover, PSA > 6.2 ng/ml was suggested as a cut-off value for predicting BCR. Conclusions In our results, cases of iPCa had clinically significant PCa, and AP and poor prognosis were also observed in some. Additionally, we found that PSA is the most clinically reliable predictor of oncologic outcome. We suggest that active treatment and diagnosis should be considered for patients with iPCa with PSA > 6.2 ng/ml.http://link.springer.com/article/10.1186/s12885-018-4955-8Prostatic neoplasmsMagnetic resonance imagingProstatectomyPrognosis |
| spellingShingle | Doo Yong Chung Dong Hoon Koh Hyeok Jun Goh Min Seok Kim Jong Soo Lee Won Sik Jang Young Deuk Choi Clinical significance and predictors of oncologic outcome after radical prostatectomy for invisible prostate cancer on multiparametric MRI BMC Cancer Prostatic neoplasms Magnetic resonance imaging Prostatectomy Prognosis |
| title | Clinical significance and predictors of oncologic outcome after radical prostatectomy for invisible prostate cancer on multiparametric MRI |
| title_full | Clinical significance and predictors of oncologic outcome after radical prostatectomy for invisible prostate cancer on multiparametric MRI |
| title_fullStr | Clinical significance and predictors of oncologic outcome after radical prostatectomy for invisible prostate cancer on multiparametric MRI |
| title_full_unstemmed | Clinical significance and predictors of oncologic outcome after radical prostatectomy for invisible prostate cancer on multiparametric MRI |
| title_short | Clinical significance and predictors of oncologic outcome after radical prostatectomy for invisible prostate cancer on multiparametric MRI |
| title_sort | clinical significance and predictors of oncologic outcome after radical prostatectomy for invisible prostate cancer on multiparametric mri |
| topic | Prostatic neoplasms Magnetic resonance imaging Prostatectomy Prognosis |
| url | http://link.springer.com/article/10.1186/s12885-018-4955-8 |
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